How are health services paid for Provide a definition for the term .pdf

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How are health services paid for? Provide a definition for the term \"third-party payer\", discuss the different payers currently operating in the market, and assess the importance of each. Please use a table format to list the information. Solution There are two main payers types: single payer and third-party payer. Single payer is when the person that obtains the health service is the same which pay for it, here relationship is direct taker and provider of health services. However, it is more common the presence of a third party payer, which is an external agent that covers the other health expenses or part of them, they are insurance companies or public social protection systems. Single Payer Third-Party Payer Type of relation with provider Direct Indirect Capability to compare Prices/Features Relatively High Almost Null Payment proportion Full Low percentage Single Payer Third-Party Payer Type of relation with provider Direct Indirect Capability to compare Prices/Features Relatively High Almost Null Payment proportion Full Low percentage.

How are health services paid for? Provide a definition for the term "third-party payer", discuss
the different payers currently operating in the market, and assess the importance of each. Please
use a table format to list the information.
Solution
There are two main payers types: single payer and third-party payer. Single payer is when the
person that obtains the health service is the same which pay for it, here relationship is direct taker
and provider of health services.
However, it is more common the presence of a third party payer, which is an external agent that
covers the other health expenses or part of them, they are insurance companies or public social
protection systems.
Single Payer
Third-Party Payer
Type of relation with provider
Direct
Indirect
Capability to compare Prices/Features
Relatively High
Almost Null
Payment proportion
Full
Low percentage
Single Payer
Third-Party Payer
Type of relation with provider
Direct
Indirect
Capability to compare Prices/Features
Relatively High
Almost Null
Payment proportion
Full
Low percentage

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The following resources have been provided to help you learn more about important concepts covered this week. Look for ways to apply these resources to this week’s activities and assignments. Ensure you: · Read “Price Transparency Needed From All Stakeholders, HFMA Task Force Says” from Modern Healthcare. https://www.modernhealthcare.com/article/20140416/NEWS/304169931/price-transparency-needed-from-all-stakeholders-hfma-task-force-saysCHAPTER 3 Current Operations of the Healthcare System LEARNING OBJECTIVES The student will be able to: ■ Identify the stakeholders of the U.S. healthcare system and their relationships with each other. ■ Discuss the importance of healthcare statistics. ■ Compare the United States to five other countries using different health statistics. ■ List at least five current statistics regarding the U.S. healthcare system. ■ Discuss complementary and alternative medicine and its role in health care. ■ Define OECD and its importance to international health care. DID YOU KNOW THAT? ■ According to the Bureau of Labor Statistics, the projection for job growth in the healthcare industry over a 10-year period is 9.8 million jobs by 2024. ■ Most healthcare workers have jobs that do not require a four-year college degree but health diagnostic and treatment providers are the most educated workers in the United States. ■ Healthcare employment is found predominantly in large states such as California, New York, Texas, and Florida. ■ Approximately 40% of U.S. adults use some form of nontraditional medicine. ■ The healthcare industry and social assistance industry reported more work-related injuries than any other private industry. ■ Life expectancy and infant mortality rates are an indication of the health of a population. ▶ Introduction The one commonality with all of the world’s healthcare systems is that they all have consumers or users of their systems. Systems were developed to provide a service to their citizens. However, the U.S. healthcare system, unlike other systems in the world, does not provide healthcare access to all of its citizens. It is a very complex system that is comprised of many public and private components. Healthcare expenditures comprise approximately 17.5% of the gross domestic product (GDP). Health care is very expensive and most citizens do not have the money to pay for health care themselves. Individuals rely on health insurance to pay a large portion of their healthcare costs. Health insurance is predominantly offered by employers. The uninsured rate remains at an all-time low with 9.1% of under 65 uninsured as of the end of 2015 according to CDC.Gov data. Generally, 2016 saw a rough increase of all the 2015 numbers. (Obamacare enrollment, 2016). The government believes this is the result of the universal mandate for individual health insurance coverage. In the United States, in order to provide healthcare services, there are several stakeholders or interested entities that participate in the indust.

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1 Chapter 2 Organization of healthcare systems 2.1 Introduction A healthcare system can be defined as a collection of interdependent organizations that, together, produce healthcare services. The list of organizations includes healthcare insurers, hospitals, doctor practices, diagnostic facilities, nursing homes, and homecare providers, self-regulation colleges for doctors and nurses, and pharmacies. While each such organization exhibits its own structures, incentives and personnel selection mechanisms, the system is typically configured with specific structures and incentives that bind its components together to varying levels of success. In general, the structure and the incentives interact and there are compatibility issues. For instance, if the system incorporates competition in its various parts, i.e. the structure will allow many organizations for the same function, incentives must be such that those organizations are motivated to compete. Unlike in a great majority of markets, a healthcare system embodies both the demand and supply sides of the market except when patients access the system at first with some symptoms. Once in the system, a patient’s demand for services takes shape through interactions with doctors who also happen to be the providers. Therefore, a major challenge for system architecture (including incentives and selection problems) is to solve doctors’ problem of split loyalty. Moreover, since insurance is desirable in the presence of uncertain and lump-sum expenditures as is the case in serious illness episodes, individual demands are typically integrated into group demands. Most countries go further and establish public health insurance in which case demand and supply for healthcare are integrated through the whole electorate’s willingness to pay for healthcare which determines the system capacity to deliver. Once, however, political processes determine resource allocation within the system, it is inevitable that equity and access issues have to be addresses whereas such issues are external to market allocation of resources. Thus: “Discussions about healthcare reform are inseparable from redistributive politics, … some level of access to healthcare will be determined by the choice of a healthcare system.” (Besley & Goouveia [1994], p.205) In light of the above definition, the analysis of healthcare systems can be described by an organizational chart, as in Figure 2.1 below, where the essential building blocks are the patients, the major providers, i.e. doctors and hospitals, and the insurers. Of course, the existence of public insurance invokes a political economy analysis as the patient- insuree votes to determine first the constitutional structure or the governance of the system and, then, its capacity by choosing investments into physical and human capital 2 ...

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Legal Principles Non- Malfeasance- Do no harm The legal principles are rules of human behavior that used to be considered as just, before the law started being written. The ethical category of Non-Malfeasance represents the doctor’s try to avoid any act or treatment plan that would hurt the patient or violate the patient’s trust, and has been popularized in the phrase “first, do no harm.” Non-Malfeasance is supported through discretion and avoidance. It is critically important that the specialist provider of highly persistent treatments uphold Non-Malfeasance. (Rodak, 2012) Beneficence- Promote the welfare of others Beneficent actions and motives have usually occupied a middle place in morality. Ordinary examples today are found in social welfare programs, policies to improve the welfare of animals etc. Distributive Justice- All involved should have equal entitlements The economic structure that each society has its laws, institutions, policies, etc. results in different distributions of economic benefits and burdens across members of the society. These economic frameworks are the result of human political processes and they continually change both across societies and within societies over time. Autonomy- non influenced decisions for both patients and physicians The term “autonomy” has appeared more and more often in the medical literature. According to this interpretation of autonomy, the goal for an autonomous person is to decide on his or her own, without undue manipulation by others. One of the first empirical papers in medical decision making on patient autonomy thus linked autonomy to the question of whether patients wanted to make decisions themselves. In the descriptive medical decision making literature, this meaning has become the default. The patient described in the informative model from the well known paper of Emanuel and Emanuel corresponds with an autonomous patient in this sense. Healthcare Rights Non- Discrimination- race, religion, sexual orientation In human social affairs, discrimination is treatment or consideration of, or making a difference in favor of or against, a person or thing based on the group, class, or category to which that person or thing is apparent to belong to rather than on individual merit. This includes treatment of an individual or group, based on their real or perceived membership in a certain group or social group. (Lamont, 2016) Credentialing/ Scope of Practice When you go for health care, identity matters a lot. You need to verify certain proofs. Following are the things that you need: Verification of identity (NAMSS, n.d.) Legal Employment Qualifications The Immigration Reform and Control Act of 1986 (IRCA) required employers to verify that all newly hired workers present "facially valid" documentation verifying the employee's identity and legal authorization to accept employment in the United States. The I-9 form or more properly ...

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The issue of fraud in health care has become a serious problem that every participant in the health delivery system must remain aware of in terms of potential and consequences. Managers in the health care system are tasked with ensuring that their staff members know the various fraud schemes as well as making sure that providers are not committing fraud themselves. A key way to accomplish this task is through education and training for fraud detection and prevention by and of health care stakeholders. The stakeholders in health care include providers, patients, organizations and institutions, the government, and the public. Also included are non-health care entities that may steal patient data for fraudulent claims and billing. Managers, therefore, are strongly advised to seek the services of health care compliance agencies to train staff, including doctors and nurses, on how to detect fraud and prevent fraud themselves. These agencies are also adept at helping to improve billing and payment functions to mitigate the risk of lost revenue through fraud and avoidance of criminal liability for the actions of providers and patients. The well-coordinated efforts of all stakeholders of health care assist in preserving the integrity of the system and make available quality services at reasonable prices for all.

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leventhalbrad49439

Question 12 (5 points) The reason that mitosis can result in the production of haploid gametes in alternation of generations is because Question 12 options: The sporophyte and gametophyte are both haploid Eggs and sperm are produced directly by the diploid sporophyte via meiosis Eggs and sperm are produced by the diploid gametophyte via mitosis Eggs and sperm are produced by the haploid gametophyte via mitosis Save Question 13 (5 points) In the fern life cycle, how does fertilization occur? Question 13 options: The sporangia on the undersides of the leaves produce gametes, which are flung our of the leaf and find each other on the ground to fuse The sporophyte produces sperm and eggs in gametangia. The sperm reach the eggs by swimming through water The gametophyte produces sperm and eggs in gametangia (antheridia and archegonia). The sperm reach the eggs by swimming through water There is no sexual reproduction in ferns Save Question 14 (5 points) The earliest land plants were most likely to have lived in which of the following habitats? Question 14 options: arid desert environments Salt water marshes Tropical rainforests fresh water wetlands Save The sporophyte and gametophyte are both haploid Eggs and sperm are produced directly by the diploid sporophyte via meiosis Eggs and sperm are produced by the diploid gametophyte via mitosis Eggs and sperm are produced by the haploid gametophyte via mitosis Solution Q12 Eggs and sperms are produced by haploid gametophyte by mitosis. The large, leafy fern is the diploid organism. On the undersurface of its fronds or leaves, its cells undergo meiosis to create haploid cells. However, these cells do not immediately unite with others to recreate the diploid state. Instead, they are shed as spores and germinate into small haploid organisms. Because the diploid organism creates spores, it is called the sporophyte generation of the life cycle. Upon reaching maturity, the haploid organism creates haploid egg and sperm cells (gametes) by mitosis . Because the haploid organism creates gametes , it is called the gametophyte generation of the life cycle. The male gametes (sperm) are then released and swim to the female egg. Fusion of the gametes creates the new diploid sporophyte, completing the life cycle. Q13 The gametophyte produces sperm and eggs in gametangia (antheridia and archegonia). The sperm reach the eggs by swimming through water The male organs or antheridia produce and shed numerous motile sperm or antherozoids. These antherozoids are armed with hair-like or whip-like cilia or flagellae and are able to swim through water; they do not travel great distances and are only released when free water is available. Only a continuous film of water is needed. They antherozoids are chemically attracted to the developing flask-like female organs or archegonia where fertilization of the single egg cell embedded in each archegonium takes place. The sporophyte has a double set of chromosomes (i.e. diploid) and i.

Question 12 (5 points)The reason that mitosis can result in the pr.pdf

Question 12 (5 points)The reason that mitosis can result in the pr.pdf

Question 12 (5 points)The reason that mitosis can result in the pr.pdf

leventhalbrad49439

peripheral circuit functions built-in to the HC12 microcontroller, that are not part of the CPU itself or the memories. Access to these is via external pins on the Microcontroller IC package. What are some of these built-in circuit functions called, and what do they do? Solution The peripheral circuit communicate with the Microcontroller using built in cirucit called BUS. The bus is a set of shared communication lines that serves as the central nervous system of the computer. Data, address, and control signals are shared by all system components via the bus. Each component connected to the bus communicates information to and from the bus via its own bus controller. The data lines,address lines, and control lines allow a specific component to access data addressed to that component. The data lines are used to communicate words to and from data. registers in the various system components such as memory, CPU, and input/output (I/O) peripherals. The address lines are used to select devices on the bus or specific data locations within memory. Devices usually have a combinational logic address decoder circuit that identifies the address code and activates the device..

peripheral circuit functions built-in to the HC12 microcontroller, t.pdf

peripheral circuit functions built-in to the HC12 microcontroller, t.pdf

peripheral circuit functions built-in to the HC12 microcontroller, t.pdf

leventhalbrad49439

Mendez Corporation has 10,000 shares of its $100 par value, 7 percent cumulative preferred stock outstanding and 50,000 shares of its $1 par value common stock outstanding. In Mendez’s first four years of operation, its board of directors paid the following cash dividends: 2011, none; 2012, $120,000; 2013, $140,000; 2014, $140,000. Determine the dividends per share and total cash dividends paid to the preferred and common stockholders during each of the four years. Solution The dividends per year on preferred stock = 10,000 x $ 100 x 7 % = $ 10,000 x $ 100 x 0.07 = $ 70,000 Dividend distribution: Year Total Dividend Amount Preferred Common 2011 - - - 2012 $120,000 $120,000 $0 2013 $140,000 $90,000 $50,000 2014 $140,000 $70,000 $70,000 Explanation: First dividend is paid to Preferred stock and then excess amount goes to common share holder. For cumulative preferred stock, any deficiency in dividend, not paid carries over to subsequent years and is added to that year\'s dividend. Preferred Dividends unpaid in 2011 = $70,000 Preferred Dividends on 2012 = $70,000 + $ 70,000 = $ 140,000 Preferred Dividends paid in 2012 = $ 120,000 Preferred Dividends shortage on 2012 = $ 20,000 As the Dividend was insufficient for preferred stocks, common stocks holder was not paid any dividend during 2011 & 2012. Preferred Dividends paid in 2013 = $ 70,000 + $ 20,000 = $ 90,000 Common Dividends paid in 2013 = $ 140,000 - $ 90,000 = $ 50,000 Preferred Dividends paid in 2014 = $ 70,000 Common Dividends paid in 2014 = $ 140,000 - $ 70,000 = $ 70,000 Computation of Dividends per share: 2011 2012 2013 2014 Preferred Stock (Dividends per share) $0 $12.00 $9.00 $7.00 Common Stock (Dividends per share) $0 $0 $1.00 $1.40 Explanation: Dividends per share = Dividend paid/No. of shares Year 2012: Dividends per share for Preferred Stock = $120,000/10,000 = $ 12 Dividend per share for Common Stock = $ 0 Year 2013: Dividends per share for Preferred Stock = $90,000/10,000 = $ 9 Dividends per share for Common Stock = $ 50,000/50,000 = $ 1 Year 2014: Dividends per share for Preferred Stock = $70,000 /10,000 = $ 7 Dividends per share for Common Stock = $ 70,000/50,000 = $ 1.40 Year Total Dividend Amount Preferred Common 2011 - - - 2012 $120,000 $120,000 $0 2013 $140,000 $90,000 $50,000 2014 $140,000 $70,000 $70,000.

Mendez Corporation has 10,000 shares of its $100 par value, 7 percen.pdf

Mendez Corporation has 10,000 shares of its $100 par value, 7 percen.pdf

Mendez Corporation has 10,000 shares of its $100 par value, 7 percen.pdf

leventhalbrad49439

If the dpy-11 and unc-31 genes are linked on the same chromosome, how many phenotypes would the F_2 progeny show? If the two genes are on different chromosomes and therefore independently assorting, how many phenotypes would you see in the F_2 worms? List the phenotype(s). Strawberry plants have varieties that flower when the days are still short, and other varieties that flower only when the days get longer. The long-day allele is dominant to the short-day allele. You\'d like to test whether or not this gene is inherited in a Mendelian fashion. When you cross between heterozygous plants and count the offspring in the F_1 generation, this is what you find: 85 plants with no flowers on short days and 35 plants with flowers on short days What would you expect the ratio of phenotypes be? What is your Chi squared value? Show your work What does this mean? Solution 2. Linked genes tend to inherit together for the next-generations. No crossing over ororoccurs independent assortment occurs. No new characters appear. Where as gegenes are on different chromosomes, they are non linked. Crossing over or independent assortment takes place. New characters appear along with parental characters. So dpy-11 & unc-31 present on same chromosome, they are linked and give only parental characters. Only 2 phenotypes appear. If the said genes present on different chromosomes, they give 4 different phenotypes 3. a. Heterozygous long day representing as Ll. When crossing or hybridization occur between these genes Ll x Ll ----------> 3:1 is the phenotypes ratio. Three are long and one is short. Chi square value can be calculated by using the formula. (O-E)^2/E O = observed phenotypes; E = Expected phenotypes.

If the dpy-11 and unc-31 genes are linked on the same chromosome, how.pdf

If the dpy-11 and unc-31 genes are linked on the same chromosome, how.pdf

If the dpy-11 and unc-31 genes are linked on the same chromosome, how.pdf

leventhalbrad49439

How does a wave formation influence the resultant waveSolution.pdf

How does a wave formation influence the resultant waveSolution.pdf

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leventhalbrad49439

Given the information regarding mitosis and meiosis, clearly and convincingly explain in your own words how an error in MITOSIS could possibly lead to a gamete containing new genetic information and thereby giving rise to a new phenotype. Use detail be comprehensive. (7 points) Solution The process of mitosis is divided into two phases: Interphase and M-phase. Interphase is further divided into G1, S and G2 phase. In G1, protein synthesis occurs for S- phase, in S phase, DNA replicates and in G2 phase, protein synthesis occurs for M-phase to start properly. Now, during S phase, the ‘2n’ nucleus converts into 4n. So, the cell entering M-phase is already ‘4n’. M-phase is the actual mitotic phase, in which the cell divides into two. It contains four phases, prophase, metaphase, anaphase and telophase. Your question is related with these four phases. In prophase, the entire DNA converts into chromosomes; the process is known as condensation of DNA. In metaphase, these chromosomes align on the equator. Now, if alignment at equator is not correct, then anaphase cannot be started due to metaphase check point. In anaphase, the aligned chromosomes move towards the opposite poles. This phase is the main phase, related with formation of gametes. The cell is already ‘4n’. ‘2n’ chromosomes move towards one end, and the rest of ‘2n’ move towards the other end. Now, suppose an error occurs in mitosis, and ‘3n’ chromosomes move towards one end, and 1n goes towards the other cell; then two gametes, ‘3n’ and n will be formed. This ‘3n’ and ‘n’ gametes are gametes having different genetic information in comparison to their ‘2n’ counterparts. Interestingly, Meiosis II will result in gamete formation is mitotic division (equational division). Haploid cells with \'2c\' amount of DNA leave Meiosis I. Now, in anaphase, suppose one chromosome\' 2c DNA migrates to one end (due to error) and no DNA migrates to the other end; then two gametes will be formed; one having all normal chromosomes + one double chromosome with 2c DNA, and the other having no DNA. Please note: normally gametes are 1n (haploid) and 1c. Suppose this gamete with double DNA (2c) fertilizes with a gamete with half DNA (1c), then the resulting cell will have “all normal chromosomes + one chromosome with ‘3c’ amount of DNA”. This condition if occurring with chromosome 21 is known as Down\' syndrome. It is important to note that errors in Mitosis result in non-disjunction; which further results in many Mendelian disorders; as well as ploidy defects. ** Hope it helps..

Given the information regarding mitosis and meiosis, clearly and con.pdf

Given the information regarding mitosis and meiosis, clearly and con.pdf

Given the information regarding mitosis and meiosis, clearly and con.pdf

leventhalbrad49439

First, look to determine what is the earliest era that fossils have been found here in Georgia. Next, see if you can find what the oldest fossil that has been found in Georgia. Give the name of the fossil, when it was found, and where the fossil was found. Give a brief description of the organism that was fossilized. Solution Trilobites are the oldest fossils found in georgia.They have been found in Georgia’s Appalachian Plateau which is present the Coosa River in Floyd County. These fossils are considered to be arthropods,Moreover they had to shed their shells to grow.As a result the fossils found in these places usually shed shells as bits of individuals or as complete individuals or as imprints of individuals..

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leventhalbrad49439

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leventhalbrad49439

explain why right and why wrong Indentify configuration (below) which I s not a correct representation of H and I. Solution option C is not correct one. Explanation: If we stretch all right hand fingers in the direction of current direction given then the thumb gives us into the board (into symbol) or out of the board (dot symbol). In the option C the field should be out of the board, so it is not correct one..

explain why right and why wrong Indentify configuration (below) whic.pdf

explain why right and why wrong Indentify configuration (below) whic.pdf

explain why right and why wrong Indentify configuration (below) whic.pdf

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80 ĐỀ THI THỬ TUYỂN SINH TIẾNG ANH VÀO 10 SỞ GD – ĐT THÀNH PHỐ HỒ CHÍ MINH NĂ...

SPLICE Working Group:Reusable Code Examples

SPLICE Working Group:Reusable Code Examples

SPLICE Working Group:Reusable Code Examples

QUATER-1-PE-HEALTH-LC2- this is just a sample of unpacked lesson

QUATER-1-PE-HEALTH-LC2- this is just a sample of unpacked lesson

QUATER-1-PE-HEALTH-LC2- this is just a sample of unpacked lesson

How to Add New Custom Addons Path in Odoo 17

How to Add New Custom Addons Path in Odoo 17

How to Add New Custom Addons Path in Odoo 17

How are health services paid for Provide a definition for the term .pdf

1. How are health services paid for? Provide a definition for the term "third-party payer", discuss the different payers currently operating in the market, and assess the importance of each. Please use a table format to list the information. Solution There are two main payers types: single payer and third-party payer. Single payer is when the person that obtains the health service is the same which pay for it, here relationship is direct taker and provider of health services. However, it is more common the presence of a third party payer, which is an external agent that covers the other health expenses or part of them, they are insurance companies or public social protection systems. Single Payer Third-Party Payer Type of relation with provider Direct Indirect Capability to compare Prices/Features Relatively High Almost Null Payment proportion Full Low percentage Single Payer Third-Party Payer Type of relation with provider Direct Indirect Capability to compare Prices/Features Relatively High Almost Null Payment proportion Full Low percentage